Sunday watch.

Opposites Attract

Jim Mcdermott May Have A Say In Pal Rosty's Health-care Package

WASHINGTON — The friendship of troubled titan Dan Rostenkowski and little-known Jim McDermott is testament to the unpredictability of human liaisons, the possibility of redemption, or maybe both.

McDermott, a very liberal Democratic congressman from Seattle, is a symbol of rectitude who chairs the House ethics committee. He's not the sort one envisions dining with his famous Ways and Means Committee colleague on a fat sirloin, gin martinis and vats of red wine at Morton's (the chairman's favorite), telling an off-color joke or two, then having a nightcap or three.

He's someone from whom many in Congress could seek help, maybe even a certain redemption, in times of personal disarray. Amid all the lawyers, small-business men and lifelong politicians, he is, as a staff member puts it, a "leavening influence, cut from a different cloth."

He's the body's lone psychiatrist. Even better, given the thin skins and big egos in Congress, he's a pediatric shrink.

But what is as notable as his unlikely comradeship with Rostenkowski is the two men's views on health-care reform.

Rostenkowski is a key supporter of President Clinton's plan, a "managed care" stratagem under which we'd all be members of big purchasing alliances, and insurance laws would be retooled supposedly to inspire greater competition in the health marketplace.

But McDermott is the biggest proponent of the most divergent alternative, the so-called single-payer plan, a far more left-leaning, Canadian-style plan in which the government would use tax revenue to pay for your care. There'd be a "global budget" that would amount to price controls on doctors and hospitals, with the federal government funneling money to the states, which would pay doctors and hospitals.

McDermott, 57, came to his conclusion that our current system is terribly flawed not in the Pacific Northwest, but in Chicago.

He was raised in Downers Grove, the son of an insurance bond underwriter and a mother who worked for Illinois Bell. He decided he wanted to be a physician at age 8 and wrote a paper on his ambition to be a psychiatrist in 8th grade.

As a student at Downers Grove High School, he made spending money by working as an elevator boy at several Loop buildings. The child of Protestant fundamentalists, he attended Wheaton College, working Great Lakes freighters in the summer.

He then headed off to medical school at the University of Illinois, leaving after one year to be a substitute teacher in the western suburbs. He returned to finish medical school, interned for a year in Buffalo, then came back for two years of research in Chicago at the Institute for Juvenile Research.

During his medical school years, he worked at Cook County Hospital, Rush-Presbyterian-St. Luke's Medical Center, MacNeal Hospital in Berwyn, the Woodlawn Mental Health Center, and Columbus Hospital in the Lincoln Park area.

He recalls seeing the highest of high-tech medicine at the institute, underfinanced care of the poor at Cook County, and well-supported care of the more well-to-do at Rush. And he certainly can't forget making rounds at Cook County one day with a prominent Oak Park internist, Edward Foley:

"We went to one bed and in it was a guy with an unusual anemia. Foley asked the senior residents about what the problem was and they couldn't figure it out. Foley wondered, `Has anybody asked this guy what he eats?' "

No. The answer was 10-cent-a-can dog food. The patient's problem was his diet.

"I saw everything," he says.

"Under single-payer (coverage), anybody could purchase the same level of care," McDermott said during a chat in his Capitol Hill office (I stayed away from the guy's couch). "What is at (Rush) would be available to anybody."

"A friend of mine runs a clinic in West Garfield Park. The way he puts it is, `What kind of care you get depends on what kind of plastic you have.' "

There is no doubt that single-payer is probably a 100-1 shot, even though it has support of nearly 100 members of Congress and 1 million signatures were just gathered to place a single-payer referendum on the ballot in California in November. And since the Democratic majority on the Ways and Means Committee is a proud and clannish lot, one can envision McDermott making compromises to help Rostenkowski fashion a winnable bill.

"The biggest problem is convincing people that government can do something," says McDermott, whose faith in the potential of government seems to have resulted from his disillusionment as a naval veteran of the Vietnam War.

Government was a great force for change, good and bad, and he got active in politics after moving to Seattle to practice psychiatry.

"We have a country that's never heard a president say a decent thing about government," he said.

"But I can remember positive things. The highway system is single-payer. There's not a single government asphalt machine; it's all done by the private sector, with money distributed to the states."